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Type 2 diabetes mellitus and Alzheimer’s disease
Open accessAbstract
Epidemiological and biological evidences support a link between type 2 diabetes mellitus (DM2) and Alzheimer's disease (AD). Persons with diabetes have a higher incidence of cognitive decline and an increased risk of developing all types of dementia. Cognitive deficits in persons with diabetes mainly affect the areas of psychomotor efficiency, attention, learning and memory, mental flexibility and speed, and executive function. The strong epidemiological association has suggested the existence of a physiopathological link. The determinants of the accelerated cognitive decline in DM2, however, are less clear. Increased cortical and subcortical atrophy have been evidenced after controlling for diabetic vascular disease and inadequate cerebral circulation. Most recent studies have focused on the role of insulin and insulin resistance as possible links between diabetes and AD. Disturbances in brain insulin signaling mechanisms may contribute to the molecular, biochemical, and histopathological lesions in AD. Hyperglycemia itself is a risk factor for cognitive dysfunction and dementia. Hypoglycemia may also have deleterious effects on cognitive function. Recurrent symptomatic and asymptomatic hypoglycemic episodes have been suggested to cause sub-clinical brain damage, and permanent cognitive impairment. Future trials are required to clarify the mechanistic link, to address the question whether cognitive decline may be prevented by an adequate metabolic control, and to elucidate the role of drugs that may cause hypoglycemic episodes.
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“Vascular risk factors including hypertension (169, 272), diabetes (43, 110), hyperlipidemia (74), and cardiovascular disease (594), as well as environment (e.g., pollution) (87-89, 207) and lifestyle (e.g., obesity, sedentary lifestyle) (281, 643) all affect cerebrovascular and BBB dysfunction (429, 571), and may influence onset and progression of AD.”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [43]
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Metadata
- Authors
- Barbagallo, M.
- Affiliations
- University of Palermo (IT)
- Corresponding author
- Barbagallo, Mario
- ORCID
- Barbagallo, Mario
- Venue
- World Journal of Diabetes
- Publisher
- Baishideng Publishing Group Inc.
- Published
- 2014
- Volume
- 5
- Issue
- 6
- Pages
- 889
- ISSN
- 1948-9358 (ISSN-L)
- PMC
- PMC4265876
- OpenAlex
- W1980458121
- Cited by
- 313
- References
- 35
- Citations by year
- 2026: 17 · 2025: 31 · 2024: 33 · 2023: 34 · 2022: 24 · 2021: 28 · 2020: 26 · 2019: 18 · 2018: 21 · 2017: 19 · 2016: 39 · 2015: 18 · 2014: 4
- FWCI
- 3.69
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- cc-by-nc
- Locations
- World Journal of Diabetes (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
- Keywords
- type 2 diabetes, Alzheimer's disease, cognitive decline, dementia risk, insulin resistance, brain insulin signaling, hyperglycemia, hypoglycemia, brain atrophy, metabolic control, cognitive impairment prevention
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